BACKGROUND: Five years of treatment provides the optimum duration of tamoxifen therapy for the prevention of breast cancer recurrence and mortality. Durations of adjuvant tamoxifen therapy less than 5 years are associated with poorer outcomes for breast cancer patients. The purpose of the study was to assess rates of tamoxifen nonpersistence (early discontinuation) in women aged 35 years or older using prescription refill data from a national prescribing database. METHODS: A cohort of 2816 women commencing tamoxifen as initial hormonal therapy was identified between January 2001 and January 2004. The cumulative tamoxifen persistence rate was calculated for these women and the relation between nonpersistence and clinical and demographic variables assessed. RESULTS: Within 1 year of commencing treatment the cumulative tamoxifen nonpersistence rate was 22.1%. This is twice the rate of treatment discontinuation observed in other studies by this time. By the end of follow-up at 3.5 years, the cumulative nonpersistence rate had increased to 35.2%. Determinants of nonpersistence identified included age and a history of antidepressant use. CONCLUSIONS: The rate of nonpersistence with tamoxifen therapy is higher than previously reported. This study demonstrates that persistence with tamoxifen cannot be assumed and raises concerns about persistence with other oral hormonal therapies for breast cancer and oral antineoplastics in general. Oncologists need to identify those at risk of nonpersistence and develop strategies to combat this barrier to treatment success.
BACKGROUND: Five years of treatment provides the optimum duration of tamoxifen therapy for the prevention of breast cancer recurrence and mortality. Durations of adjuvant tamoxifen therapy less than 5 years are associated with poorer outcomes for breast cancerpatients. The purpose of the study was to assess rates of tamoxifen nonpersistence (early discontinuation) in women aged 35 years or older using prescription refill data from a national prescribing database. METHODS: A cohort of 2816 women commencing tamoxifen as initial hormonal therapy was identified between January 2001 and January 2004. The cumulative tamoxifen persistence rate was calculated for these women and the relation between nonpersistence and clinical and demographic variables assessed. RESULTS: Within 1 year of commencing treatment the cumulative tamoxifen nonpersistence rate was 22.1%. This is twice the rate of treatment discontinuation observed in other studies by this time. By the end of follow-up at 3.5 years, the cumulative nonpersistence rate had increased to 35.2%. Determinants of nonpersistence identified included age and a history of antidepressant use. CONCLUSIONS: The rate of nonpersistence with tamoxifen therapy is higher than previously reported. This study demonstrates that persistence with tamoxifen cannot be assumed and raises concerns about persistence with other oral hormonal therapies for breast cancer and oral antineoplastics in general. Oncologists need to identify those at risk of nonpersistence and develop strategies to combat this barrier to treatment success.
Authors: Victoria K Shanmugam; James McCloskey; Beth Elston; Sandra J Allison; Jennifer Eng-Wong Journal: Breast Cancer Res Treat Date: 2011-11-11 Impact factor: 4.872
Authors: Vikki Ho; Romain Pasquet; Shaman Luo; Gang Chen; Paul Goss; Dongsheng Tu; Philip Lazarus; Harriet Richardson Journal: Breast Cancer Res Treat Date: 2020-08-01 Impact factor: 4.872
Authors: Carmel Jacobs; Brian Hutton; Sasha Mazzarello; Stephanie Smith; Anil Joy; Eitan Amir; Mohammed F K Ibrahim; Nancy Gregario; Kelly Daigle; Lori Eggert; Mark Clemons Journal: Support Care Cancer Date: 2015-05-03 Impact factor: 3.603
Authors: Vanessa B Sheppard; Leigh Anne Faul; George Luta; Jonathan D Clapp; Rachel L Yung; Judy Huei-Yu Wang; Gretchen Kimmick; Claudine Isaacs; Michelle Tallarico; William T Barry; Brandelyn N Pitcher; Clifford Hudis; Eric P Winer; Harvey J Cohen; Hyman B Muss; Arti Hurria; Jeanne S Mandelblatt Journal: J Clin Oncol Date: 2014-06-16 Impact factor: 44.544